HomeMy WebLinkAboutHeating Permit 95-0018 -- - -----�--r�
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��F PRIp � ��� i-' � 3. Yellow - C C nVactor
� yx � �_ �R� � �R LAKE � TYPE OF STRUCTURE
u m �9��A �T S.E. Permii No. / 5 "' � 8 Single Family Two-Family Multi-Family
���� PFt10R LAKE, 372
Commercial Industrial Pubiic Other
10 / PERMIT
Date -�S PID # 3�' �-DU �"" O U3 - D �OB VALUATION FEE
Site Address L-, �P/3 o wo,„ S� �0 -$1,000 2% oi job value, min. $20.00
Lot Biock Addition $�.�� -$10,000 $20.00 for the first $1,000 plus $1.25 for each additional
$100.00 or fraction thereof to and inciuding $10,000.
Owner's Name � L Lt £.�� r r z.
$10,001 -$50,000 $132.50 for the first $10,000 pius $1.00 for each addi-
Address �o �l 3 �O �-o �-�- fi tional $100.00 or fraction thereof, to and including
— $50,000.
Heating Contractor /d a a�,/E ��` �9� . e 4�-
Address � v . �o � � / /�a s� � � � f . /j/1,�.. �"Sa 6 a $50.001 and over $532.50 for the first $50,000 plus $7.50 for each addi-
'/ tional $1,000 or fraction thereof.
Telephone # _ �",2,r3 ' 7 / 7 "�
ing permit includes one rough-in and one firtal inspection.
Furnace Make & Model TYPE OF SYSTEM CLOSED DUE TO II be biiled at $25.00 each.
Warm Air Plants
Model Size Gravity INACTIVITY 8/30/O 1 ord must be submitted with building nermit number before build-
Conn. Load Mechanical cy will be issued.
Air Conditioning
Fuel Flue Size Vent. System J�AT CALGIlLATIONS REQUtRED with number of supply and return openings listed
HFJITING OR POWER PLANT per room with CFM's per opening. New structures or additions send floor plan with sup-
Suppiy Openings Steam pfy and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AMD
Return Openings Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRlOR lAKE, 4629 Dakota St.
Radiation S.E. Prior Lake, MN. 55372.
tnput Output Special Devices
City Hall business hours are 8 a.m. - 4:30 p.m.
Edr.
Other Devices ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CAlL CITY NALL
Cfm.
447-4230.
�'ia,��-c,�,'f ��� r, TYPE OF WORK I hereby apply for mechanical systems permit and I acknowledge that the information
Alterations � Replacement ��Vew Construction above is complete and accurate; that the work will be in conformance with the ordi-
nances and oodes of the city and with the state building/mechanical cades; that this form
Repair Est. Comp. Date does not become a permit until signed by the BUILDING OFFICIAL; that the work will be
� �� in accordartce with the a in the case of all work which requires review and
Est. Cost $ 7Q0 - d� Building Permit �k � approval of plans.
HEATING PERMIT FEE $ �Zo - �� J /S- �,S
!
STATE SURCHARGE $ .50 Appli ' n ure Date
TOTAL PERMIT FEES $ �_Sc5 Receipt # 2 � � C r ---!-=.� ��
Bu' ing Official's Signature D�te